Surgical Stapling Apparatus Including Buttress Attachment

ABSTRACT

A surgical stapling apparatus, a surgical stapling loading unit and a staple cartridge assembly are provided including a buttress releasably disposed against a tissue contacting surface of a cartridge assembly and/or an anvil assembly, a continuous length of suture securing a respective surgical buttress against the respective the tissue contacting surface, wherein the suture extends transversely across the respective surgical buttress, and a retaining feature securing each suture to the respective cartridge assembly and anvil assembly. The retaining feature may include an adhesive adhering the suture to a surface of the cartridge assembly and/or anvil assembly. The adhesive may adheres the suture to multiple locations along the surface of the cartridge assembly and/or anvil assembly.

BACKGROUND

1. Technical Field

The present disclosure relates to a surgical stapling apparatus and,more particularly, to a surgical stapling apparatus including adetachable surgical buttress for an anvil assembly and/or a staplecartridge assembly.

2. Background of Related Art

Surgical stapling instruments that are used to sequentially orsimultaneously apply one or more rows of fasteners to join segments ofbody tissues are well known in the art. The fasteners are typically inthe form of surgical staples but two part polymeric fasteners can alsobe utilized. Such devices generally include a pair of jaws to clamptherebetween the body tissues to be joined. Typically, one of the jawmembers includes or supports a staple cartridge assembly whichaccommodates a plurality of staples arranged in at least two lateralrows while the other jaw member has an anvil assembly that defines asurface for forming the staple legs as the staples are driven from thestaple cartridge assembly.

When the stapling instrument is actuated, longitudinally translatingcams contact staple drive members in one of the jaws which in turn actsupon staple pushers to sequentially or simultaneously eject the staplesfrom the staple cartridge assembly. A blade can travel between thestaple rows to longitudinally cut and/or open the stapled tissue betweenthe rows of staples. Such instruments are disclosed, for example, inU.S. Pat. No. 3,079,606 and U.S. Pat. No. 3, 490,675, the entiredisclosures of which are hereby incorporated by reference herein.

When stapling relatively thin or fragile tissues, it may be important toeffectively seal the staple line against air or fluid leakage.Additionally, it is often necessary to reinforce the staple line againstthe tissue to prevent tears in the tissue or pulling of the staplesthrough the tissue. One method of preventing tears or pull throughinvolves the placement of a biocompatible fabric reinforcing material,or a “buttress,” between the staple and the underlying tissue. In thismethod, a layer of buttress material is placed against the tissue andthe tissue is stapled in conventional manner. In more recent methods,the layer of buttress is positioned on the surgical stapling apparatusitself prior to stapling the tissue. Some surgical staplers utilizefasteners or clips to temporarily connect buttress material to each ofthe jaws of the staplers, i.e., one disposed on the staple cartridgeassembly and the other on the anvil assembly.

It is a desire of the present application to provide a staple linereinforcement material that is securely attached to a jaw of a staplinginstrument, while being releasable therefrom. It would also be desirableto provide a staple line reinforcement material or buttress that isreleasably attached to a stapler jaw by a member that is removed fromthe site with the stapler after use. Accordingly, it is an object ofthis disclosure to meet the aforementioned desires.

SUMMARY

The present disclosure relates to a surgical stapling apparatusincluding a surgical buttress.

According to an aspect of the present disclosure, a surgical staplingapparatus is provided and includes a first jaw and a second jaw movablerelative to one another to perform a surgical stapling operation wherebystaples are fired into target tissue. The surgical stapling apparatuscomprises a housing; a handle supported by the housing; an elongatedbody extending distally from the housing and having a distal end adaptedto releasably engage a loading unit; and a loading unit supportable on adistal end of the housing.

According to another aspect of the present disclosure, a surgicalstapling loading unit including a first jaw and a second jaw movablerelative to one another to perform a surgical stapling operation wherebystaples are fired into target tissue is provided.

The loading unit includes a cartridge assembly supportable on one of thefirst jaw and the second jaw, the cartridge assembly having a tissuecontacting surface defining a longitudinally extending elongate slot anda plurality of staple retaining slots formed therein, wherein thecartridge assembly includes a surgical staple loaded into each stapleretaining slot. The loading unit includes an anvil assembly supported onanother of the first jaw and the second jaw, the anvil assemblyincluding an anvil plate having a tissue contacting surface defining alongitudinally extending elongate slot and a plurality of staple formingpockets.

The loading unit includes a surgical buttress releasably disposedagainst at least one of the tissue contacting surface of the cartridgeassembly and the tissue contacting surface of the anvil assembly, eachsurgical buttress including a body portion configured and dimensioned tooverlie the plurality of staple retaining slots and the plurality ofstaple forming pockets of the respective cartridge assembly and anvilassembly, the body portion defining a distal edge and a proximal edge.

The loading unit includes a length of suture securing a respectivesurgical buttress against the at least one of the tissue contactingsurface of the cartridge assembly and the tissue contacting surface ofthe anvil assembly, wherein the suture extends transversely across therespective surgical buttress.

The loading unit includes a retaining feature securing each suture tothe respective cartridge assembly and anvil assembly.

Portions of the continuous suture may extend across both a distalportion and a proximal portion of each surgical buttress. Portions ofthe continuous suture may extend across a rear surface of the respectivecartridge assembly and anvil assembly. Portions of the continuous suturemay be threaded through the surgical buttress along opposed sides of thesurgical buttress.

The retaining feature may include an adhesive adhering the suture to asurface of the respective cartridge assembly and anvil assembly. Theadhesive may adhere the suture to multiple locations along the surfaceof the respective cartridge assembly and anvil assembly. The adhesivemay adhere a portion of the suture to the surface of the cartridgeassembly at a location near the distal edge of the surgical buttress.The adhesive may adhere a portion of the suture to the surface of theanvil assembly at a location near the proximal edge of the surgicalbuttress.

Each surgical buttress may include a tab extending from each side edgeof the body portion, and an aperture formed in each tab, wherein thesuture extends through each aperture.

Each of the cartridge assembly and the anvil assembly may include aplurality of grooves formed in a side surface of the respectivecartridge assembly and anvil assembly, wherein each groove is configuredand dimensioned to receive a length of suture therein, and whereingrooves are formed near opposed distal side edges and opposed proximalside edges of the respective cartridge assembly and anvil assembly.

According to a further aspect of the present disclosure, a surgicalstaple cartridge assembly configured for use with a surgical staplingapparatus, is provided. The staple cartridge assembly comprises a staplecartridge body defining a tissue contacting surface; a centrallongitudinally extending knife slot formed in the cartridge body; and aplurality of longitudinally extending rows of staple retaining pocketsformed in the cartridge body.

The staple cartridge assembly further comprises a surgical staple loadedin each staple retaining slots; a plurality of pushers slidablysupported for vertical translation in the cartridge body and operativelyassociated with the surgical staples; and an actuation sled slidablysupported in longitudinal translation in the cartridge body andoperatively associated with the plurality of pushers.

The staple cartridge assembly also comprises a surgical buttressreleasably disposed against the tissue contacting surface of thecartridge body, the surgical buttress including a body portionconfigured and dimensioned to overlie the plurality of staple retainingslots of the cartridge body, the body portion of the surgical buttressdefining a distal edge and a proximal edge.

The staple cartridge assembly additionally comprises a continuous lengthof suture securing the surgical buttress against the tissue contactingsurface of the cartridge body, wherein the suture extends transverselyacross the surgical buttress, wherein portions of the continuous sutureextend across both a distal portion and a proximal portion of eachsurgical buttress; and a retaining feature securing the suture to thecartridge body, wherein the retaining feature includes an adhesiveadhering the suture to a surface of the cartridge body.

Portions of the continuous suture may extend across a rear surface ofthe cartridge body. Portions of the continuous suture may be threadedthrough the surgical buttress along opposed sides of the surgicalbuttress.

The adhesive may adhere the suture along the surface of the cartridgebody. The adhesive may adhere a portion of the suture to the surface ofthe cartridge body at a location near the distal edge of the surgicalbuttress.

The surgical buttress may include a tab extending from each side edge ofthe body portion, and an aperture formed in each tab, wherein the sutureextends through each aperture.

BRIEF DESCRIPTION OF THE DRAWINGS

The present disclosure will be further described with reference to theaccompanying drawings, wherein like reference numerals refer to likeparts in the several views, and wherein:

FIG. 1 is a perspective view of a surgical stapling apparatus accordingto an embodiment of the present disclosure;

FIG. 2 is a perspective view, with parts separated, of an end effectorof the surgical stapling apparatus of FIG. 1;

FIG. 3 is a top, perspective view of a surgical buttress of the presentdisclosure, shown in a planar condition;

FIG. 4 is a top, perspective view of a distal end of a cartridgereceiving jaw of the surgical stapling apparatus of FIG. 1, illustratingthe surgical buttress of FIG. 3 secured thereto a staple cartridgeassembly loaded therein;

FIG. 5 is a cross-sectional view of the cartridge receiving jaw of FIG.4, as taken through 5-5 of FIG. 4;

FIG. 6 is an enlarged view of the indicated area of detail of FIG. 4;

FIG. 7 is a bottom, perspective view of a distal end of an anvil jaw ofthe surgical stapling apparatus of FIG. 1, illustrating the surgicalbuttress of FIG. 3 secured thereto;

FIG. 8 is a cross-sectional view of the anvil jaw of FIG. 7, as takenthrough 8-8 of FIG. 7;

FIG. 9 is a top, plan view of the anvil jaw of FIG. 7;

FIG. 10 is a schematic, perspective view of a distal end of thecartridge assembly and the anvil assembly, illustrating an alternateembodiment of a retaining feature of the present application.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the presently disclosed staple line reinforcement for asurgical stapling apparatus will now be described in detail withreference to the drawings, in which like reference numerals designateidentical or corresponding elements in each of the several views. In thedrawings and in the description that follows, the term “proximal,” as istraditional, will refer to the end of the stapling apparatus which isclosest to the operator, while the term “distal” will refer to the endof the apparatus which is farthest from the operator.

Referring now to FIG. 1, there is disclosed a linear surgical staplingapparatus, generally referred to as 10. In the interest of brevity, thisdisclosure will focus primarily on a buttress utilized in a loading unit100, e.g., a single use loading unit (“SULU”) or a disposable loadingunit (“DLU”). For simplicity, hereinafter, SULU or DLU will be referredto as “DLU,” but it should be understood to include either or both a DLUor SULU. An exemplary example of this type of surgical staplinginstrument is disclosed in U.S. Pat. No. 8,011,555, the entiredisclosure of which is incorporated by reference herein. The loadingunit is removable and replaceable. Additionally or alternatively, thestaple cartridge assembly can be removable and replaceable.

With reference to FIG. 1, surgical stapling apparatus 10 generallyincludes a handle assembly 12 and an elongate body 14 extending distallyfrom handle assembly 12. A DLU 100 is releasably secured to the distalend of elongate body 14. DLU 100 includes a cartridge receiving jaw 102configured to selectively receive a cartridge assembly 200 housing aplurality of surgical fasteners or staples 223 (see FIG. 4). DLU 100further includes an anvil jaw 104, supporting an anvil assembly 300,movably secured in relation to cartridge receiving jaw 102. Handleassembly 12 includes a stationary handle member 22, a movable handlemember 24, and a barrel portion 26. An articulation lever 30 is mountedon the forward end of barrel portion 26 adjacent rotatable member 28 tofacilitate articulation of DLU 100. A pair of knobs 32 is movablypositioned along barrel portion 26. Knobs 32 are advanced distally toapproximate or close jaws 102, 104, and refracted proximally tounapproximate or open jaws 102, 104. Actuation of movable handle member24 applies lines of staples 223 to tissue. In order to properly orientjaws 102, 104 relative to the tissue to be stapled, surgical staplingapparatus 10 is additionally provided with a rotatable member 28 on theforward end of barrel portion 26. Rotation of rotatable member 28relative to handle assembly 12 rotates elongate body 14 and DLU 100relative to handle assembly 12 so as to properly orient jaws 102, 104relative to the tissue to be stapled.

As seen in FIGS. 2-4, cartridge receiving jaw 102 is dimensioned andconfigured to selectively receive a staple cartridge assembly 200therein. Staple cartridge assembly 200 includes retention slots 222formed therein for receiving a plurality of fasteners or staples 223 andpushers 226. A central longitudinal slot 234 is formed in and extendsalong the length of staple cartridge assembly 200 to facilitate passagetherethrough of knife blade 156 of a drive bar 150 of surgical staplingapparatus 10. During operation of surgical stapling apparatus 10, anactuation sled 228 translates through staple cartridge assembly 200 toadvance cam wedges of actuation sled 228 into sequential contact withpushers 226, to cause pushers 226 to translate vertically withinretention slots 222 and urge staples 223 from slots 222 into stapleforming pockets 312 of anvil plate 310 of anvil assembly 300 (see FIGS.2 and 8). Reference may once again be made to U.S. Pat. No. 8,011,555,the entire disclosure of which is incorporated by reference herein, fora detailed discussion of the construction and operation of staplecartridge assembly 200.

As seen in FIGS. 4-9, at least one of cartridge receiving jaw 102(including staple cartridge assembly 200), and anvil jaw 104 (includinganvil assembly 300), includes a surgical buttress 500 operativelysecured to a respective tissue contacting surface thereof.

As seen in FIG. 3, each surgical buttress 500 includes a rectangularcentral body portion 502 configured and dimensioned to overlie at leasta portion of the staple retention slots 222 of the staple cartridgeassembly 200, and staple forming pockets 312 of anvil plate 310 of anvilassembly 300. Body portion 502 defines a distal edge 502 a, a proximaledge 502 b, and a pair of side edges 502 c, 502 d.

Each surgical buttress 500 includes a first flap or tab 504 a extendingfrom a first side edge 502 c of body portion 502, and a second flap ortab 504 b extending from a second side edge 502 d of body portion 502.Each flap 504 a, 504 b defines a respective aperture 506 a, 506 b formedtherein, wherein apertures 506 a, 506 b are located at about a mid pointof a length of body portion 502. Each flap 504 a, 504 b is substantiallytriangular in configuration. It is contemplated that buttress 500 mayinclude a line of reduced thickness along side edges 502 c, 502 d toenable flaps 504 a, 504 b to be bent out of plane relative to a planedefined by body portion 502. The line of reduced thickness may also beused to facilitate removal of the flap or flaps from the main or bodyportion of the buttress.

The material from which the surgical buttress 500 is formed may bebioabsorbable or non-bioabsorbable. It should be understood that anycombination of natural, synthetic, bioabsorbable and non-bioabsorbablematerials may be used to form the buttress material. The buttressmaterial may be porous or non-porous, combination of porous andnon-porous layers. The non-porous buttress material may be utilized toretard or prevent tissue ingrowth from surrounding tissues therebyacting as an adhesion barrier and preventing the formation of unwantedscar tissue.

Additional exemplary materials for surgical buttresses 500 for use withthe surgical stapling devices disclosed herein are set forth in commonlyassigned U.S. Pat. Nos. 5,542,594; 5,908,427; 5,964,774; and 6,045,560,and commonly assigned U.S. Application Publication Nos. 2006/0085034,filed on Apr. 20, 2006; and 2006/0135992, filed on Jun. 22, 2006, theentire contents of each of which is incorporated herein by reference.

In an embodiment, surgical buttresses 500 may be fabricated from asuitable biocompatible and bioabsorbable material. Surgical buttresses500 may also be fabricated from a non-absorbent material which does notretain fluid, for example, surgical buttresses 500 may be fabricatedfrom “BIOSYN™” (a synthetic polyester, commercially available from TycoHealthcare Group, LP d/b/a COVIDIEN, North Haven, Conn.), which is madefrom “GLYCOMER 631” (a block copolymer) which is a synthetic polyestercomposed of glycolide, dioxanone and trimethylene carbonate. Thebuttress can be a film, mesh, woven, non-woven, braided material orother material. It can be made by molding, drawing, weaving, using meltblown or spun bonding techniques or other techniques.

One block of the resulting copolymer contains randomly combined unitsderived from p-dioxanone (1,4-dioxan-2-one) and trimethylene carbonate(1,3-dioxan-2-one). A second block of the copolymer contains randomlycombined units derived from glycolide and p-dioxanone. The resultingpolyester is an ABA triblock terpolymer possessing about 60% glycolide,about 14% dioxanone, and about 26% trimethylene carbonate. Anotherco-polymer of glycolide trimethylene carbonate can be used to make thebuttress.

Surgical buttresses 500 may be secured (i.e., from the manufacturer)onto anvil assembly 300 and/or cartridge-receiving-jaw102/cartridge-assembly 200 combo either during the manufacturing process(i.e., pre-loaded) or prior to the surgical procedure while in theoperating room. Additional or replacement surgical buttresses 500 foranvil assembly 300 and/or cartridge-receiving-jaw 102/cartridge-assembly200 combo may be secured to either anvil assembly 300 orcartridge-receiving-jaw 102/cartridge-assembly 200 combo as needed ordesired.

As seen in FIGS. 4-6, surgical buttress 500 is secured to cartridgereceiving jaw 102 and to surgical cartridge assembly 200 by a length ofa first suture “S1.” The length of suture is desirably continuous sothat only a single strand for each buttress is used. In any of theembodiments disclosed herein, more than one strand may be used to securethe buttress. With surgical buttress 500 placed against the tissuecontacting surface of surgical cartridge assembly 200, such that bodyportion 502 of surgical buttress 500 overlies staple retention slots 222of the staple cartridge assembly 200, first suture “S1” is used tostrap, tie or otherwise secure surgical buttress 500 to thecartridge-receiving-jaw 102/cartridge-assembly 200 combo.

In particular, a first portion “S1a” of first suture “S1” is extendedtransversely across a distal end of staple cartridge assembly 200 (and adistal end of cartridge receiving jaw 102) in relative close proximityto distal edge 502 a of surgical buttress 500. First suture “S1” is thenextended to wrapped around each side of staple cartridge assembly 200(and a distal end of cartridge receiving jaw 102) such that a pair ofsecond portions “S1b” of first suture “S1” extend beneath staplecartridge assembly 200 (and distal end of cartridge receiving jaw 102).The pair of second portions “S1b” of first suture “S1” are crossed andthen threaded through respective apertures 506 a, 506 b of flap 504 a,504 b, such that a pair of third portions “S1c” of first suture “S1”engages respective flaps 504 a, 504 b. First suture “S1” is then onceagain extended to wrapped around each side of staple cartridge assembly200 (and now a mid portion of cartridge receiving jaw 102) such that apair of fourth portions “S1d” of first suture “S1” extend beneath staplecartridge assembly 200 (and mid portion of cartridge receiving jaw 102).The pair of fourth portions “S1d” of first suture “S1” are crossed andthen extended to wrapped around each side of staple cartridge assembly200 (and a proximal end of cartridge receiving jaw 102) such that thepair of fourth portions “S1d” of first suture “S1” extend above staplecartridge assembly 200 (and proximal end of cartridge receiving jaw102). The remaining free ends “S1e” (i.e., a pair of fifth portions) offirst suture “S1” are then tied or secured to one another, whileextending transversely across the proximal end of staple cartridgeassembly 200 (and the proximal end of cartridge receiving jaw 102) inrelative close proximity to proximal edge 502 b of surgical buttress500.

In accordance with the present disclosure, a retaining feature isprovided to secure first portion “S1” of first suture “S1” in relativelyclose proximity to distal edge 502 a of surgical buttress 500. Inparticular, the retaining feature may include a dab of adhesive 110applied against staple cartridge assembly 200 (or a distal end ofcartridge receiving jaw 102) at a location to adhere or secure firstportion “S1a” of first suture “S1” in relatively close proximity todistal edge 502 a of surgical buttress 500 prior to second portions“S1b” of first suture “S1” extending around each side and beneath staplecartridge assembly 200 (and a distal end of cartridge receiving jaw102). Alternatively, in any of the embodiments disclosed herein, thesuture may be attached to the jaw using welding, mechanical features, orother techniques. In alternate embodiments, a retaining feature may alsobe provided to secure fifth portion “S1e” of first suture “S1” inrelatively close proximity to proximal edge 502 b of surgical buttress500.

Additionally, first portion “S1a” of first suture “S1” is adhered orsecured to staple cartridge assembly 200 (or a distal end of cartridgereceiving jaw 102) at a location such that first portion “S1a” of firstsuture “S1” extends transversely across central longitudinal slot 234 ofstaple cartridge assembly 200.

In accordance with the present disclosure, it is contemplated that theretaining features may include a tacking of first suture “S1” againststaple cartridge assembly 200 (or a distal end of cartridge receivingjaw 102), at a location to maintain first portion “S1a” of first suture“S1” in relatively close proximity to distal edge 502 a of surgicalbuttress 500, by a welding process or the like.

In a further embodiment, as seen in FIG. 10, it is contemplated that thecartridge assembly 200 may include a groove or notch 112 a formed ineach side surface of staple cartridge assembly 200 (and/or cartridgereceiving jaw 102), at a location to maintain first portion “S1a” offirst suture “S1” in relatively close proximity to distal edge 502 a ofsurgical buttress 500, and which are configured to receive a segment offirst suture “S1” therein. A groove or notch 112 b may also be formed ineach side surface of staple cartridge assembly 200 (and/or cartridgereceiving jaw 102), at a location to maintain fifth portion “S1e” offirst suture “S1” in relatively close proximity to proximal edge 502 bof surgical buttress 500, and which are configured to receive a segmentof first suture “S1” therein.

Reference may be made to U.S. patent application Ser. No. 13/404,134,filed on Feb. 24, 2012, and to U.S. Pat. No. 8,011,555, the entirecontent of each of which is incorporated herein by reference, for adetailed disclosure of the configuration of groove-type or notch-typeretaining features.

In accordance with the present disclosure, it is contemplated thatsurgical buttress 500 may be secured or tied solely to staple cartridgeassembly 200. As such, a staple cartridge assembly 200, including asurgical buttress 500 secured or tied thereto, may be loaded into thecartridge receiving jaw 102 of surgical stapling apparatus 10.

As seen in FIGS. 7-9, surgical buttress 500 is secured to anvil jaw 104by a continuous length of a second suture “S2.” With surgical buttress500 placed against the tissue contacting surface of anvil plate 310 ofanvil assembly 300 (or anvil jaw 104), such that body portion 502 ofsurgical buttress 500 overlies staple forming pockets 312 of anvil plate310, second suture “S2” is used to strap, tie or otherwise securesurgical buttress 500 to the anvil assembly 300 (and/or anvil jaw 104).

In particular, a first portion “S2a” of second suture “S2” is extendedtransversely across a distal end of anvil jaw 104 in relative closeproximity to distal edge 502 a of surgical buttress 500. Second suture“S2” is then extended to wrapped around each side of the anvil assembly300 (and/or anvil jaw 104) such that a pair of second portions “S2b” ofsecond suture “S2” extend beneath the anvil assembly 300 (and/or anviljaw 104). The pair of second portions “S2b” of second suture “S2” arecrossed and then threaded through respective apertures 506 a, 506 b offlap 504 a, 504 b, such that a pair of third portions “S2c” of secondsuture “S2” engages respective flaps 504 a, 504 b. Second suture “S2” isthen once again extended to wrapped around each side of the anvilassembly 300 (and/or anvil jaw 104) such that a pair of fourth portions“S2d” of second suture “S2” extend beneath the anvil assembly 300(and/or anvil jaw 104). The pair of fourth portions “S2d” of secondsuture “S2” are crossed and then extended to wrapped around each side ofthe anvil assembly 300 (and/or anvil jaw 104) such that the pair offourth portions “S2d” of second suture “S2” extend above the anvilassembly 300 (and/or anvil jaw 104). The remaining free ends “S2e”(i.e., a pair of fifth portions) of second suture “S2” are then tied orsecured to one another, while extending transversely across the proximalend of the anvil assembly 300 (and/or anvil jaw 104) in relative closeproximity to proximal edge 502 b of surgical buttress 500.

Also in accordance with the present disclosure, a retaining feature isprovided to secure fifth portions “S2e” of second suture “S2” inrelatively close proximity to proximal edge 502 b of surgical buttress500. In particular, the retaining feature may include a dab of adhesive120 applied against the anvil assembly 300 (and/or anvil jaw 104) at alocation to maintain fifth portions “S2e” of second suture “S2” inrelatively close proximity to proximal edge 502 b of surgical buttress500 following the fifth portions “S2e” being tied or otherwise joinedtogether above staple the anvil assembly 300 (and/or anvil jaw 104).Preferably, the dab of adhesive 120 is applied to a rear surface of theanvil assembly 300 (and/or anvil jaw 104). In alternate embodiments aretaining feature may also be provided to secure first portion “S2a” ofsecond suture “S2” in relatively close proximity to distal edge 502 a ofsurgical buttress 500.

Additionally, first portion “S2a” of second suture “S2” is adhered orsecured to the anvil assembly 300 (and/or anvil jaw 104) at a locationsuch that first portion “S2a” of second suture “S2” extends transverselyacross central a longitudinal knife receiving slot formed in the anvilplate 310 of anvil assembly 300.

In an embodiment, it is contemplated that the retaining features mayinclude a tacking of second suture “S2” against the anvil assembly 300(and/or anvil jaw 104) at a location to maintain fifth portion “S2e” ofsecond suture “S2” in relatively close proximity to proximal edge 502 aof surgical buttress 500, by a welding process or the like.

As seen in FIG. 10, it is contemplated that the anvil assembly 300 mayinclude a groove or notch 114 a formed in a side surface of the anvilassembly 300 (and/or anvil jaw 104), at a location to maintain firstportion “S2a” of second suture “S2” in relatively close proximity todistal edge 502 a of surgical buttress 500, which is configured toreceive a segment of second suture “S2” therein. A groove or notch 114 bmay also be formed in each side surface of the anvil assembly 300(and/or anvil jaw 104), at a location to maintain fifth portion “S2e” ofsecond suture “S2” in relatively close proximity to proximal edge 502 bof surgical buttress 500, and which are configured to receive a segmentof second suture “S2” therein.

Reference may once again be made to U.S. patent application Ser. No.13/404,134, filed on Feb. 24, 2012, and to U.S. Pat. No. 8,011,555, theentire content of each of which is incorporated herein by reference, fora detailed disclosure of the configuration of groove-type or notch-typeretaining features.

Buttresses 500 are provided to reinforce and seal staple lines appliedto tissue by surgical stapling apparatus 10. Cartridge assembly 200 andanvil assembly 300 are particularly configured to allow surgicalbuttresses 500 to be localized on inwardly facing surfaces of cartridgeassembly 200 and anvil assembly 300 in order to facilitate passage ofsurgical stapling apparatus 10 into the body of a patient without riskof tearing or wrinkling of the respective buttresses as surgicalstapling apparatus 10 is inserted into and manipulated within the bodyof a patient.

In operation, with DLU 100 coupled to a distal end of elongated body 14of surgical stapling apparatus 10, and with buttresses 500 loaded ontoeach of anvil assembly 300 and cartridge assembly 200, surgical staplingapparatus 10 is used in accordance with methods known by those skilledin the art. Once anvil assembly 300 and cartridge assembly 200 areclamped onto tissue, surgical stapling apparatus 10 is fired. In firingsurgical stapling apparatus 10, a knife blade 156

As the knife blade 156 begins to travel distally, the knife blade 156substantially simultaneously cuts through a central section of the fifthportions “S1e, S2e” of respective first and second sutures “S1, S2” ofanvil assembly 300 and cartridge assembly 200, thereby respectivelyfreeing the proximal ends of cartridge buttress 500 a from cartridgeassembly 200. Thereby loosening suture “S1” around cartridge buttress500 a. As the knife blade 156 is moved distally, the knife blade slicesor cuts longitudinally through both buttresses 500, thereby dividing thebuttresses 500 substantially in half.

Additionally, as the knife blade 156 approaches the distal-mostposition, the knife blade 156 cuts through first portion “S1a” of firstsuture “S1” which extends transversely across central longitudinal slot234 of staple cartridge assembly 200 and through first portion “S2a” ofsecond suture “S2” which extends transversely across central alongitudinal knife receiving slot 314 (see FIGS. 2 and 8) formed in theanvil plate 310 of anvil assembly 300, thereby respectively freeing thedistal ends of anvil buttress 500 b from anvil assembly 300. Therebyloosening sutures “S2” around anvil buttress 500 b.

Since sutures “S1, S2” are adhered or otherwise secured to respectiveunderlying components (i.e., cartridge jaw 102 and/or cartridge assembly200, and assembly jaw 104 and/or anvil assembly 300), sutures “S1, S2”remain adhered or otherwise secured thereto following a firing ofsurgical stapling apparatus 10 and during a removal or withdrawal of DLU100 from the operative site, thereby also withdrawing sutures “S1, S2”from the operative site.

In any of the embodiments disclosed herein, the sutures may comprisestraps, cables, lines, tabs, belts or the like and are made fromnon-absorbable or bioabsorbable materials.

In any of the embodiments disclosed herein, the suture extends acrossthe knife slot and is cut by the knife at least once. Desirably, thesuture is attached to the stapler components such as the anvil assembly,cartridge assembly or channel, or both, so that each piece of the one ormore pieces of suture per buttress is removed with the staplerinstrument after it is fired.

While the above-described embodiments surgical staplers incorporatingthe use of movable knife blades to sever and release surgical buttressesfrom the tissue contacting surfaces of the anvil assembly and thecartridge assembly have been shown and described in relation toendoscopic surgical staplers, it is envisioned and within the scope ofthe present disclosure that any of the above-embodiments may beincorporated into any type of surgical stapler, including and notlimited to open surgical staplers, such as, for example, linear surgicalstaplers and transverse surgical staplers.

It will be understood that various modifications may be made to theembodiments disclosed herein. For example, the stapling apparatus neednot apply staples but rather may apply two part fasteners as is known inthe art. Further, the length of the linear row of staples or fastenersmay be modified to meet the requirements of a particular surgicalprocedure. Thus, the length of a single stroke of the actuation shaftand/or the length of the linear row of staples and/or fasteners within adisposable loading unit may be varied accordingly. Therefore, the abovedescription should not be construed as limiting, but merely asexemplifications of preferred embodiments. Those skilled in the art willenvision other modifications within the scope and spirit of the claimsappended thereto.

What is claimed is:
 1. A surgical stapling apparatus including a firstjaw and a second jaw movable relative to one another to perform asurgical stapling operation whereby staples are fired into targettissue, the surgical stapling apparatus comprising: a housing; a handlesupported by the housing; an elongated body extending distally from thehousing and having a distal end adapted to releasably engage a loadingunit; and a loading unit supportable on a distal end of the housing, theloading unit including: a cartridge assembly supportable on one of thefirst jaw and the second jaw, the cartridge assembly having a tissuecontacting surface defining a longitudinally extending elongate slot anda plurality of staple retaining slots formed therein, wherein thecartridge assembly includes a surgical staple loaded into each stapleretaining slot; an anvil assembly supported on another of the first jawand the second jaw, the anvil assembly including an anvil plate having atissue contacting surface defining a longitudinally extending elongateslot and a plurality of staple forming pockets; a surgical buttressreleasably disposed against at least one of the tissue contactingsurface of the cartridge assembly and the tissue contacting surface ofthe anvil assembly, each surgical buttress including a body portionconfigured and dimensioned to overlie the plurality of staple retainingslots and the plurality of staple forming pockets of the respectivecartridge assembly and anvil assembly, the body portion defining adistal edge and a proximal edge; a length of suture securing arespective surgical buttress against the at least one of the tissuecontacting surface of the cartridge assembly and the tissue contactingsurface of the anvil assembly, wherein the suture extends transverselyacross the respective surgical buttress; and a retaining featuresecuring each suture to the respective cartridge assembly and anvilassembly.
 2. The surgical stapling apparatus according to claim 1,wherein portions of the suture extend across both a distal portion and aproximal portion of each surgical buttress.
 3. The surgical staplingapparatus according to claim 2, wherein portions of the suture extendacross a rear surface of the respective cartridge assembly and anvilassembly.
 4. The surgical stapling apparatus according to claim 3,wherein portions of the suture are threaded through the surgicalbuttress along opposed sides of the surgical buttress.
 5. The surgicalstapling apparatus according to claim 4, wherein the retaining featureincludes an adhesive adhering the suture to a surface of the respectivecartridge assembly and anvil assembly.
 6. The surgical staplingapparatus according to claim 5, wherein the adhesive adheres the sutureto multiple locations along the surface of the respective cartridgeassembly and anvil assembly.
 7. The surgical stapling apparatusaccording to claim 6, wherein the adhesive adheres a portion of thesuture to the surface of the cartridge assembly at a location near thedistal edge of the surgical buttress.
 8. The surgical stapling apparatusaccording to claim 7, wherein the adhesive adheres a portion of thesuture to the surface of the anvil assembly at a location near theproximal edge of the surgical buttress.
 9. The surgical staplingapparatus according to claim 8, wherein each surgical buttress includesa tab extending from each side edge of the body portion, and an apertureformed in each tab, wherein the suture extends through each aperture.10. The surgical stapling apparatus according to claim 4, wherein eachof the cartridge assembly and anvil assembly includes a plurality ofgrooves formed in a side surface of the respective cartridge assemblyand anvil assembly, wherein each groove is configured and dimensioned toreceive a length of suture therein, and wherein grooves are formed nearopposed distal side edges and opposed proximal side edges of therespective cartridge assembly and anvil assembly.
 11. A surgicalstapling loading unit including a first jaw and a second jaw movablerelative to one another to perform a surgical stapling operation wherebystaples are fired into target tissue, the loading unit comprising: acartridge assembly supportable on one of the first jaw and the secondjaw, the cartridge assembly having a tissue contacting surface defininga longitudinally extending elongate slot and a plurality of stapleretaining slots formed therein, wherein the cartridge assembly includesa surgical staple loaded into each staple retaining slot; an anvilassembly supported on another of the first jaw and the second jaw, theanvil assembly including an anvil plate having a tissue contactingsurface defining a longitudinally extending elongate slot and aplurality of staple forming pockets; a surgical buttress releasablydisposed against at least one of the tissue contacting surface of thecartridge assembly and the tissue contacting surface of the anvilassembly, each surgical buttress including a body portion configured anddimensioned to overlie the plurality of staple retaining slots and theplurality of staple forming pockets of the respective cartridge assemblyand anvil assembly, the body portion defining a distal edge and aproximal edge; a length of suture securing a respective surgicalbuttress against the at least one of the tissue contacting surface ofthe cartridge assembly and the tissue contacting surface of the anvilassembly, wherein the suture extends transversely across the respectivesurgical buttress; and a retaining feature securing each suture to therespective cartridge assembly and anvil assembly.
 12. The loading unitaccording to claim 11, wherein portions of the suture extend across botha distal portion and a proximal portion of each surgical buttress. 13.The loading unit according to claim 12, wherein portions of the sutureextend across a rear surface of the respective cartridge assembly andanvil assembly.
 14. The loading unit according to claim 13, whereinportions of the suture are threaded through the surgical buttress alongopposed sides of the surgical buttress.
 15. The loading unit accordingto claim 14, wherein the retaining feature includes an adhesive adheringthe suture to a surface of the respective cartridge assembly and anvilassembly.
 16. The loading unit according to claim 15, wherein theadhesive adheres the suture to multiple locations along the surface ofthe respective cartridge assembly and anvil assembly.
 17. The loadingunit according to claim 16, wherein the adhesive adheres a portion ofthe suture to the surface of the cartridge assembly at a location nearthe distal edge of the surgical buttress.
 18. The loading unit accordingto claim 17, wherein the adhesive adheres a portion of the suture to thesurface of the anvil assembly at a location near the proximal edge ofthe surgical buttress.
 19. The loading unit according to claim 18,wherein each surgical buttress includes a tab extending from each sideedge of the body portion, and an aperture formed in each tab, whereinthe suture extends through each aperture.
 20. The loading unit accordingto claim 14, wherein each of the cartridge assembly and anvil assemblyincludes a plurality of grooves formed in a side surface of therespective cartridge assembly and anvil assembly, wherein each groove isconfigured and dimensioned to receive a length of suture therein, andwherein grooves are formed near opposed distal side edges and opposedproximal side edges of the respective cartridge assembly and anvilassembly.
 21. A surgical staple cartridge assembly configured for usewith a surgical stapling apparatus, the staple cartridge assemblycomprising: a staple cartridge body defining: a tissue contactingsurface; a central longitudinally extending knife slot formed in thecartridge body; and a plurality of longitudinally extending rows ofstaple retaining pockets formed in the cartridge body; a surgical stapleloaded in each staple retaining slots; a plurality of pushers slidablysupported for vertical translation in the cartridge body and operativelyassociated with the surgical staples; an actuation sled slidablysupported in longitudinal translation in the cartridge body andoperatively associated with the plurality of pushers; a surgicalbuttress releasably disposed against the tissue contacting surface ofthe cartridge body, the surgical buttress including a body portionconfigured and dimensioned to overlie the plurality of staple retainingslots of the cartridge body, the body portion of the surgical buttressdefining a distal edge and a proximal edge; a length of suture securingthe surgical buttress against the tissue contacting surface of thecartridge body, wherein the suture extends transversely across thesurgical buttress, wherein portions of the continuous suture extendacross both a distal portion and a proximal portion of each surgicalbuttress; and a retaining feature securing the suture to the cartridgebody, wherein the retaining feature includes an adhesive adhering thesuture to a surface of the cartridge body.
 22. The staple cartridgeassembly according to claim 21, wherein portions of the suture extendacross a rear surface of the cartridge body.
 23. The staple cartridgeassembly according to claim 21, wherein portions of the suture arethreaded through the surgical buttress along opposed sides of thesurgical buttress.
 24. The staple cartridge assembly according to claim23, wherein the adhesive adheres the suture to multiple locations alongthe surface of the cartridge body.
 25. The staple cartridge assemblyaccording to claim 24, wherein the adhesive adheres a portion of thesuture to the surface of the cartridge body at a location near thedistal edge of the surgical buttress.
 26. The staple cartridge assemblyaccording to claim 25, wherein the adhesive adheres a portion of thesuture to the surface of the cartridge body at a location near theproximal edge of the surgical buttress.
 27. The staple cartridgeassembly according to claim 26, wherein the surgical buttress includes atab extending from each side edge of the body portion, and an apertureformed in each tab, wherein the suture extends through each aperture.